柴胡二两 黄芩十八铢 人参十八铢 甘草十八铢(炙) 生姜十八铢(切) 半夏五
枚
(洗)
上前七味,以水四升,煮取二升,去滓〔法〕,下芒硝大黄桑螵蛸,煮取一升半,去滓
〔法
柴胡加桑螵蛸汤,此亦有方而无证。大都用柴胡汤,其邪必从少阳而来,热及于阳明者,
加芒硝。热实于阳明者,加大黄。其邪入阳明,而后可议下。然里虚之应下者,加芒硝当佐
人参以安中,若加大黄,当佐桑螵蛸固阴续绝以安下,此少阳而有阳明症者,下之之方也。
桂枝三两 芍药六两 甘草二两(炙) 生姜三两(切) 大枣十二枚(擘) 大黄二
两(去
皮)
上六味, 咀〔法〕,以水七升,煮取三升,去滓〔法〕,温服一升。
大黄入于桂枝汤中,欲其破脾实而不伤阴也。大黄非治太阴之药,脾实腹痛是肠中燥矢
不去
阴之
双解
枳实三枚(炙) 栀子十四枚(擘) 香豉一升(绵裹)
上三味,以清浆水七升空煎,取四升〔法〕,纳枳实、栀子,煮取二升〔法〕,纳豉,更
煮
五六枚。
枳实栀子豉汤,微汗、微下方也。大都瘥复必虚实相兼,故汗之不欲其大汗,下之不欲
其大
栀、
枳实
柴胡十分 枳实十分(炙) 芍药十分 甘草十分(炙)
上四味,各十分,捣筛〔法〕,白饮和服方寸匕〔法〕,日三服〔法〕。
四逆散,与四逆汤药品皆异者,此四逆由于热深而厥也。《素问·厥论》云∶阴气虚则
阳气
微热
芍药
此
药
柴胡二两,黄芩十八铢,人参十八铢,甘草十八铢(炙),生姜十八铢(切),半夏五枚(洗)。以上七味药,用水四升,煎煮至二升,滤去药渣,加入芒硝、大黄、桑螵蛸,再煎煮至一升半,滤去药渣。
柴胡加桑螵蛸汤,此处只有方剂而没有对应的病症描述。大凡使用柴胡汤,病邪必然从少阳经传来,若热邪波及阳明经,则加芒硝;若热邪实结于阳明经,则加大黄。只有当病邪传入阳明经后,才可考虑使用下法。然而对于里虚而应当使用下法的患者,加芒硝时应当佐助人参以安护中焦;若加大黄,则应当佐助桑螵蛸以固护阴液、接续绝气以安护下焦。这是治疗少阳病兼见阳明症状时使用下法的方剂。
桂枝三两,芍药六两,甘草二两(炙),生姜三两(切),大枣十二枚(擘开),大黄二两(去皮)。以上六味药,捣碎,用水七升,煎煮至三升,滤去药渣,温服一升。
将大黄放入桂枝汤中,意在破除脾实的积滞而不损伤阴液。大黄并非治疗太阴病的药物,脾实腹痛是由于肠道中的燥屎不去所致,此方具有阴阳双解的作用。
枳实三枚(炙),栀子十四枚(擘开),香豉一升(用丝织品包裹)。以上三味药,用清浆水七升先空煎至四升,加入枳实、栀子,煎煮至二升,再加入香豉,继续煎煮至五六升。
枳实栀子豉汤,属于微发汗、微通下的方剂。大凡大病初愈后复发,必定虚实夹杂,因此发汗不追求大汗,攻下不追求峻下。
柴胡十分,枳实十分(炙),芍药十分,甘草十分(炙)。以上四味药,各取十分,捣碎过筛,用白米汤调和服用一方寸匕,每日服用三次。
四逆散与四逆汤的药物组成完全不同,此处的四肢厥冷是由于热邪深重导致的“热深厥亦深”。《素问·厥论》中说:阴气虚则阳气……(原文此处有缺漏或截断,仅翻译可见部分)……微热……芍药……此……药……
Chai Hu (Bupleuri Radix) 2 liang, Huang Qin (Scutellariae Radix) 18 zhu, Ren Shen (Ginseng Radix et Rhizoma) 18 zhu, Gan Cao (Glycyrrhizae Radix et Rhizoma) 18 zhu (roasted), Sheng Jiang (Zingiberis Rhizoma Recens) 18 zhu (sliced), Ban Xia (Pinelliae Rhizoma) 5 pieces (washed). The above seven herbs are decocted in four sheng of water until two sheng remain. The dregs are removed, then Mang Xiao (Natrii Sulfas), Da Huang (Rhei Radix et Rhizoma), and Sang Piao Xiao (Mantis Ootheca) are added. The mixture is decocted again until one and a half sheng remains, and the dregs are removed.
Chai Hu Jia Sang Piao Xiao Tang (Bupleurum Decoction with Mantis Ootheca): This entry provides only the formula without specific symptoms. Generally, when Chai Hu Tang (Bupleurum Decoction) is used, the pathogenic factor must have originated from the Shaoyang (Lesser Yang) channel. If the heat extends to the Yangming (Yang Brightness) channel, Mang Xiao (Natrii Sulfas) is added. If there is excess heat solidified in the Yangming channel, Da Huang (Rhei Radix et Rhizoma) is added. Only after the pathogen has entered the Yangming channel can purgative methods be considered. However, for patients with interior deficiency who require purgation, if Mang Xiao (Natrii Sulfas) is added, it should be assisted by Ren Shen (Ginseng Radix et Rhizoma) to stabilize the Middle Jiao. If Da Huang (Rhei Radix et Rhizoma) is added, it should be assisted by Sang Piao Xiao (Mantis Ootheca) to secure Yin and restore vitality to stabilize the Lower Jiao. This is a formula for using purgatives in cases where Shaoyyang disease presents with Yangming symptoms.
Gui Zhi (Cinnamomi Ramulus) 3 liang, Bai Shao (Paeoniae Radix Alba) 6 liang, Gan Cao (Glycyrrhizae Radix et Rhizoma) 2 liang (roasted), Sheng Jiang (Zingiberis Rhizoma Recens) 3 liang (sliced), Da Zao (Jujubae Fructus) 12 pieces (torn open), Da Huang (Rhei Radix et Rhizoma) 2 liang (bark removed). The above six herbs are crushed, decocted in seven sheng of water until three sheng remain, the dregs are removed, and one sheng is taken warm.
Adding Da Huang (Rhei Radix et Rhizoma) into Gui Zhi Tang (Cinnamon Twig Decoction) aims to break up spleen excess accumulation without damaging Yin. Da Huang (Rhei Radix et Rhizoma) is not a herb for treating Taiyin (Greater Yin) disease; spleen excess abdominal pain is caused by dry feces remaining in the intestines. This formula achieves a dual resolution of Yin and Yang.
Zhi Shi (Aurantii Fructus Immaturus) 3 pieces (roasted), Zhi Zi (Gardeniae Fructus) 14 pieces (torn open), Chi Dou (Sojae Semen Praeparatum) 1 sheng (wrapped in silk). The above three herbs are first boiled alone in seven sheng of clear fermented grain water until four sheng remain. Then Zhi Shi (Aurantii Fructus Immaturus) and Zhi Zi (Gardeniae Fructus) are added and decocted until two sheng remain. Finally, Chi Dou (Sojae Semen Praeparatum) is added, and it is boiled further until five or six sheng remain.
Zhi Shi Zhi Zi Chi Dou Tang (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction) is a mild diaphoretic and mild purgative formula. Generally, relapse after recovery involves both deficiency and excess. Therefore, sweating should not induce profuse perspiration, and purging should not be drastic.
Chai Hu (Bupleuri Radix) 10 fen, Zhi Shi (Aurantii Fructus Immaturus) 10 fen (roasted), Bai Shao (Paeoniae Radix Alba) 10 fen, Gan Cao (Glycyrrhizae Radix et Rhizoma) 10 fen (roasted). The above four herbs, each measured at 10 fen, are crushed and sifted. They are mixed with white rice drink and administered as one cun bi (a square-inch measure) per dose, taken three times daily.
Si Ni San (Frigid Extremities Powder) differs completely in composition from Si Ni Tang (Frigid Extremities Decoction). The cold extremities here are due to deep heat causing厥 (Jue - reversal cold). The *Su Wen · Jue Lun* (Plain Questions: Treatise on Reversal Cold) states: When Yin Qi is deficient, Yang Qi... [text cuts off] ... slight heat ... Bai Shao (Paeoniae Radix Alba) ... this ... herb ...